N.Y. State Senate Passes No-Fault Auto Insurance Fraud Measures

Corrected 2:49 p.m.

March 22, 2012 marked nine years to the day when Alice Ross, a 71-year-old grandmother, was killed in a no-fault auto insurance fraud scheme, and the day when the New York State Senate passed three bills aimed at stemming the multimillion-dollar stage-and-fraud crime trend.

The first of the individual laws allows for retroactive cancellation of a new auto policy if payment was later found to be fraudulent, preventing criminal rings from illegally financing the policies that allow them to enact a scheme.

It also allows victims of a no-fault accident to receive benefits from their own insurer. New York law did not previously provide benefits to victims and their families even if the accident was ruled to have been intentional.

The second piece of legislation makes faking an automobile accident, participating in a staged accident or submitting false claims to collect benefits a felony offense. The third makes the act of hiring another person to commit no-fault fraud, submitting or collecting its benefits a felony.

The laws also give law enforcement officials tools to investigate no-fault fraud schemes and prosecute those who planned and carried them out.

The bills must now pass through the Assembly. An article in the New York Daily News quoted a spokesman for Assembly Speaker Sheldon Silver calling auto insurance fraud “extremely disturbing” and promising that “we’ll be reviewing this package of bills with a goal of protecting consumers.”

New York Insurance Association, Inc. President Ellen Melchionni says she is “extremely encouraged by what’s happened in the Senate”, mentioning that the trial bar supports the bills. Melchionni believes that the legislation should be passed shortly after the Assembly agrees on the state budget.

“In our opinion, these 3 bills really go after the individuals that are really, truly intending to commit fraud. It’s low-hanging fruit if they are intending to fight [this],” she says, citing a recent insurance-fraud bust which implicated 36 people and robbed the state’s no-fault system of more than $279 million.

“When they close one office, it pops up 3 blocks away with a different doctor and billing name,” says Melchionni of the “pervasive” nature of insurance fraud. Melchionni adds that a regulation adopted by Lawsky "requiring providers to sign a form to attest to the fact that their license is not used for fraud might go a long way in closing down medical mills.”

“Not to mention that the costs of these crimes are passed on to consumers, and we all end up paying,” she emphasizes.

Future reforms will incrementally give law-enforcement and insurance companies time to investigate such crimes, require medical providers to confirm that prescribed treatments were necessary to the victim’s health, enforce treatment procedures, and ensure a legal limit on medical service fees.

Florida, another no-fault state, has also recently pursued legislative reforms.

Corrected to show that a measure requiring providers to sign a form attesting their license is not used for fraud is a regulation, not legislation.